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Loretto Partners with Clarity Clinical Research to test new COVID-19 drug for seniors

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Loretto took early action at the start of the pandemic to protect our community’s most vulnerable population — an effort that resulted in less than 1% of residents testing positive for the virus.

Now looking forward to future protection against COVID-19, Clarity Clinical Research is working with Loretto to launch a clinical trial with an investigational treatment for people who were exposed (or potentially exposed) to COVID-19 to test the medication’s ability to reduce the risk of becoming infected for those living in long term care facilities.

The drug is a post-exposure prophylactic and the active ingredient, Nitazoxanide, is already approved by the FDA for acute viral respiratory illnesses.

“Nitazoxanide has been used to treat an estimated 400 million people worldwide. This means we already know the safety performance and side effects of this drug,” says Lisa Sonneborn, MA, LMHC, Site Director for Clarity Clinical Research. Clarity Clinical Research in East Syracuse is one of only two sites statewide leading this study.

“The benefit of this study is that it only requires one person to test positive for COVID-19,because that allows Clarity Clinical Research to open up participation in this trial with all residents at the facility who may have been exposed to the individual who tested positive,” says Julie Sheedy, Chief Marketing & Engagement Officer at Loretto. “Eligibility does not require every participant to test positive for COVID-19.”

The study is being offered exclusively to qualifying Loretto residents at The Bernardine, Sedgwick Heights, Buckley Landing, and The Nottingham.

“Residents at these facilities tend to have the highest levels of independence and can meet the study’s requirements, including making medical decisions and diary keeping,” Sheedy says.

This is one of many studies the clinical research company in East Syracuse offers. Clarity has been a leader in Alzheimer’s and dementia research, focusing on evaluating treatments to slow or stop the progression of memory loss. The research clinic has found new and innovative ways to continue enrolling patients into Alzheimer’s trials despite the challenges caused by COVID-19. Using telehealth and virtual memory screening, Clarity has long supported national trials in the search for a cure for Alzheimer’s disease.

In addition to partnering with Clarity Clinical Research to offer innovative trials to help prevent the spread of COVID-19, Loretto has also partnered with other companies that offer groundbreaking technology to keep its residents safe and healthy.

Loretto has had a long partnership with ImagineMIC, a health-monitoring device that tracks a person’s vital signs and other important health indicators 24/7. The health data is collected and monitored by a team of physicians and medical staff 24 hours a day. Participants of the telehealth device have access to that team of medical professionals around the clock.

In April, Loretto rolled out MonitorMe, a second-generation health-monitoring device also made by ImagineMIC. To date, close to 100 Loretto residents and program participants have enrolled in these two telehealth programs and the results are overwhelmingly positive.

COVID-19 has certainly changed the way healthcare providers care for patients. Loretto is committed to offering new technology and forging new partnerships, while Clarity Clinical Research continues to be on the cutting edge of offering innovative studies that benefit our community. Their individual efforts and their partnership will help keep our most vulnerable population safe and healthy.

Innovation in Health Care

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by Kathryn Ruscitto

Monday, June 29, 2020

We clearly have a long way to go to get past this virus. So many challenges, and so many thanks for all front line clinicians and staff who have gotten us this far.

There are some bright spots of innovation emerging from the chaos. As with any period of complexity, we are also presented with great opportunities for change.

The key will be improving the disaster we have seen in supply chain. For any of us who tried to buy masks, gloves or other protective materials for organizations, the fluctuating quality, costs and global fraud involved in obtaining that equipment suggests we need to remold our manufacturing and supply chain. Innovators, please jump in!

We need to examine access to care and the disparities that emerged across urban and rural communities. This means determining how we use data and best practices to better assess and understand these disparities and create a response system for the next pandemic. This also means better systems for addressing vaccine and treatment protocols.

Kathryn Ruscitto

The isolation and fear that has emerged for at-risk elders living at home or in long-term care facilities needs attention. How do we provide better protection and support? Great opportunity exists to apply emergency management algorithms to protecting important community members.

While these trends suggest new opportunities, innovation in health care is already happening on many fronts.

In talking to graduates and startups, I keep stressing this time as an chance to advance bold new ideas and new products. Some examples of promising new startups from the Blackstone LaunchPad powered by Techstars at Syracuse University include:

MedUX: medux-llc.com is an award-winning medical product company based on user-centered design. Its first product is a wearable/portable IV system for people in hospital, infusion center and home infusion settings. This product is also used in emergency first response and military situations, offering patients infusion treatment without being tethered to an IV pole.

PAANI: paanisolutions.com, a venture developed by two female founders, addresses a public health crisis in India, where 163 million people lack access to clean water. Using a traditional sari cloth, they engineered a culturally appropriate filtration system to capture pathogens and particulates.

Visos: visosvr.com is a VR platform specifically for medical applications, working in conjunction with a team of advisors that include leaders in the health industry.

Promptous: promptous.com is led by a team building a digital health innovation venture in the insurtech space. It is a blockchain-powered platform to make access to dental benefits simple, seamless and transparent. Their goal is to help make dental benefits affordable and accessible to the 74 millions who go without dental insurance.

In-Spire: news.syr.edu/blog/2018/04/24/engineering-and-computer-science-students-win-panasci-business-plan-competition-with-wearable-inhaler, is a sleek wristband asthma inhaler developed by two female founders who won the CNY Biotech Accelerator Medical Device Innovation.

SugEx: dailyorange.com/2019/10/su-senior-invents-watch-monitor-glucose-levels-diabetes-diagnosis , a wearable technology to make glucose monitoring easier, was developed by an engineering student and industrial design student (one of whom was unexpectedly diagnosed with juvenile diabetes while in college).

If you have any interest in being a mentor for a promising student startup, head to launchpad.syr.edu. Mentors play a key role in accelerating learning about application in a clinical setting. I’ve served as a mentor for MedUX and have enjoyed watching many a great product be launched.

It’s a challenging time, and if you encounter a student concerned about the future, share the exciting startup ideas that are emerging for health care and the opportunities that they can help to explore.

Kathryn Ruscitto, Advisor, can be reached on LinkedIn at Kathrynruscitto or at krusct@gmail.com.

For further ideas on innovation in health care:

covidinnovations.com

rockhealth.com/portfolio

startupdigest.com/digests/health

builtin.com/healthcare-technology

Daniel Alexander, MD, Joins Auburn Orthopedic Specialists

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By Molly English-Bowers

Monday, August 29, 2022

Auburn Orthopedic Specialists (AOS), affiliated with Auburn Community Hospital, has added another orthopedic surgeon to its growing practice. Daniel Alexander, MD, is one of the most respected and accomplished orthopedic surgeons in upstate New York, with 20 years of experience performing more than 20,000 surgeries. Recognized for both his professional achievements and his community service, Dr. Alexander will join AOS in early October.

“I am thrilled to join the team at Auburn Orthopedic Specialists, and to be a part of Auburn Hospital and this community,” says Dr. Alexander, whose specialty is joint replacement surgery. “The medical professionals at AOS have built a first-class orthopedic practice, and I look forward to helping them grow this practice.”

He will join four physicians and three physician assistants with expertise in a variety of fields ranging from hand and wrist surgery to sports medicine and joint replacement.

Dr. Alexander is a leader in ROSA (Robotic Surgical Assistant) total knee arthroplasty and has performed arthroscopic surgeries and treated orthopedic trauma and fracture fixation. A Fellow of the American Academy of Orthopedic Surgeons, he’s at the forefront of orthopedic care and research.

“We are thrilled to have someone of Dr. Alexander’s stature and experience join AOS and the hospital,” says Scott Berlucchi, President and CEO of Auburn Community Hospital. “His experience and desire to stay on top of the latest orthopedic procedures and technology will be a tremendous asset to our community.”

Dr. Alexander will join the physicians at Auburn Orthopedic Specialists’ total joint replacement program and work closely with referring primary care providers and patients to ensure excellence in care from diagnosis to rehabilitation.

“All of the surgeons at AOS are doing remarkable work and I am impressed with the investments Auburn Community Hospital leadership has made in new technology to allow this practice to grow and serve the community,” Dr. Alexander says.

Reaching Residents in Other Ways

Daniel Alexander, MD, has an impressive medical resume, but his community service is also noteworthy, particularly his reach to the underserved. He was instrumental in building the new state-of-the-art emergency department at Newark-Wayne Community Hospital, and is responsible for building a community center in one of Buffalo’s poorest neighborhoods, where he grew up.

Dr. Alexander also helped build a Boys and Girls Club in Geneva, New York, to connect and empower young people to reach their full potential. He currently co-chairs “Boldly Buffalo,” a fundraising campaign to support his alma mater, the University of Buffalo (UB), including the UB medical school. Under his leadership, the campaign will soon meet its goal of raising $1 billion.

Dr. Alexander received his medical degree from the State University of New York at Buffalo and completed his training at Henry Ford Hospital in Detroit, Michigan. He is the founder of Finger Lakes Bone and Joint Center and Open MRI of the Finger Lakes, and was Chair of Orthopedics for Rochester Regional Health eastern region. He will soon depart his current position at Newark Wayne Community Hospital and Clifton Springs Hospital.

For the Upstate Transplant Program, Nurses Are the Linchpin

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By Thomas Crocker

Thursday, August 18, 2022

Nurses play an indispensable part in helping the Upstate Transplant Program at Upstate University Hospital burnish its reputation as one of the leading kidney and pancreas transplant providers in New York state.

The Upstate Transplant Program numbers 40 people, including 14 nurses. Here, a portion of the team gathers alongside a Mercy Flight Central (MFC) helicopter on the helipad atop Upstate University Hospital. A short time before, the helicopter had completed an emergency transport to the hospital.
 

One of the first programs of its kind in the Northeast, and the only approved pediatric transplant program in Central New York, the Upstate Transplant Program has a long history of providing adult and pediatric kidney transplants. In 2016, it broadened its scope to include adult pancreas transplants, making it the second-largest pancreas transplant program in the state.

Upstate Transplant surgeons and nephrologists have, combined, more than 150 years of transplant experience, with more than 1,000 deceased donor kidney transplants and more than 400 living donor kidney transplants. The program’s location in the geographic center of New York state makes it a convenient choice not only for patients across the state but also for those in neighboring states.

Shorter-than-average wait times and excellent outcomes are hallmarks of the Upstate Transplant Program. For example, from Jan. 1, 2016, to June 30, 2021, 37.5% of the program’s adult kidney transplant patients received a transplant within two years of listing compared with a national average of 25.7%, according to the Scientific Registry of Transplant Recipients (SRTR). The program’s transplant success rates equal, and in many cases surpass, national averages, according to the SRTR and United Network for Organ Sharing.

“Transplant is perhaps the most highly specialized field in medicine,” says Reza Saidi, MD, FACS, FICS, Chief of Transplantation at Upstate University Hospital and Associate Professor of Surgery at Upstate Medical University. “Patients require extensive evaluation and workup not just from a medical standpoint, but also from psychosocial, dietary, financial and postoperative standpoints. This is why we have a large, multidisciplinary transplant team of more than 40 clinicians and other professionals. Nursing is an integral component.”

Clockwise from lower left, transplant coordinators Ashley Ryan, BSN, RN; Lori Daratt, RN, BSN, CMSRN;
Lavell Jones, MSN, RN, CCTC; and Tanya Mercurio, MSN, RN

Dedicated to helping determine patients’ candidacy and to educating and shepherding them through a years-long continuum of care, the 14-person nursing team — half of whom are master’s-prepared — includes seven RN transplant coordinators. Three of the transplant coordinators are certified by the American Board for Transplant Certification; the remaining four are currently pursuing certification in clinical transplant coordination. These transplant coordinators serve as patient advocates, navigators, liaisons and educators along every step of the transplant process.

“Nurses are at the center of everything,” says Janine Morris, EdD, MPH, RN, Administrator at the Upstate Transplant Program. “They establish contact with patients following referral, and explain and help patients navigate the process for getting waitlisted. If difficulties arise, nurses help patients obtain what they need to continue moving toward waitlisting. Our nurses have a deep knowledge of the multidisciplinary team, and they know when another member of the team, such as a social worker or pharmacist, is best positioned to help with a specific issue.”

Transplant Coordinator Ashely Ryan BSN, RN, and Transplant Nurse Practitioner Reeba Thankachan, MS, NP-C.
“Our program gives a chance to patients who might otherwise be rejected as transplant candidates by other programs. Our physicians are extremely skilled at finding the right organ for the right recipient, even in complex cases. As a result, we waitlist and transplant sicker patients than do other programs, and we’re able to offer specialized forms of care.”
— Janine Morris, EdD, MPH, RN, Administrator of the Upstate Transplant Program

From Referral to Listing

From the moment patients enter the Upstate Transplant Program’s care, a pre-transplant nurse coordinator starts building a relationship with them.

“The best word to describe the transplant coordinator’s role is ‘advocate,’” says Galina Rivera, BSN, RN, CCTC, Transplant Coordinator at the Upstate Transplant Program. “We advocate for patients in all phases of the transplant process. We get to know patients deeply and comprehensively, whereas other members of the multidisciplinary team may only see patients through the lens of their area of expertise.”

For prospective organ recipients, the transplant process begins following referral from a specialist in the community or dialysis center. Patients attend a two-hour virtual education session with the pre-transplant coordinator, a nephrologist and other members of the multidisciplinary team.

“Once patients complete their pre-evaluation education session, they make an in-person visit to our clinic for a medical intake appointment that includes meeting with the pre-transplant coordinator and other members of the team,” Rivera says. “We discuss all aspects of the requirements to be listed for transplant. Afterward, the pre-transplant coordinator helps facilitate any testing that patients need, such as cardiac testing, imaging or a colonoscopy. If necessary, we work with patients to improve compliance if they have a history of noncompliance with dialysis. Our goal is to help patients get to the point where they’ve done everything they need for the selection committee to consider them for listing for a new organ.”

The pre-transplant coordinators present patients during the selection committee’s weekly meetings, when the multidisciplinary team gathers to discuss candidates for transplant. They summarize each patient’s history and evaluation process for the committee.

“Once listing takes place, we maintain an active wait list of patients, which currently features more than 300 people on the adult kidney transplant list alone,” Rivera says. “We maintain up-to-date information for each patient and help ensure that they continue to undergo any necessary routine testing. Our objective is to make sure every patient on the list is always ready to receive a transplant if an organ becomes available.”

Transplant patient Martell Taylor (center) with Transplant Coordinator Lavell Jones, MSN, RN, CCTC, and Dr. Reza Saidi, surgeon, chief of the Transplant Clinic and associate professor of surgery at Upstate Medical University.
 

Post-Transplant Care

After receiving a transplant, patients transition into the care of a post-transplant coordinator.

“Before patients are discharged from the hospital, we educate them on how to document their temperature, blood pressure and heart rate; how to recognize signs and symptoms of infection; and what rejection means,” says Lavell Jones, MSN, RN, CCTC, Living Donor Coordinator at the Upstate Transplant Program. “This helps them stay on the right track to have a successful transplant.”

The post-transplant coordinator also ensures patients leave the hospital with the medications they need to maintain the donated organ and prevent rejection. A patient meets with the post-transplant coordinator and a physician in the clinic on a regular basis, as often as twice a week at first. The post-transplant coordinator monitors the patient’s lab results, discusses the results with the physician, and relays changes in therapy — such as adjustments to immunosuppressant dosage — to the patient. Moving forward, the post-transplant coordinator serves as the patient’s point of contact for questions about symptoms, medications and lab results.

“Initially, patients follow up with the transplant surgeon, and then later, long-term follow-up takes place with the transplant nephrologist,” Rivera says. “Consequently, the transplant coordinators work closely with the physicians in our program. Once patients are stable, few medication changes are necessary. If a referring nephrologist is interested in assuming that aspect of long-term care for the patient, our team works with the nephrologist to facilitate the transition of care back to the community nephrologist.”

From left, Rauf Shahbazov, MD, PhD, MRCS Ed, FEBS; Sharon Loerzel, PA;
Matthew Hanlon, MD; and Reza Saidi, MD, FACS, FICS, with the da Vinci Xi surgical system.
 

Living Donor Care Coordination

The Upstate Transplant Program’s volumes are increasing, and that’s especially true of living donor transplants. In 2021, the program’s organ transplants increased by 50%, and living donor transplants rose by 78%. Living donors work with a living donor coordinator as they move through the donation process.

While Jones assists with care coordination for organ recipients, she specializes in living donor coordination, caring for the donor from referral to donation.

“When a referral arrives, I screen the donor for factors that might rule out donation, review their cases with another provider on the team to determine whether we can move forward, and then coordinate lab testing, collection of a 24-hour urine test and evaluation,” Jones says. “After evaluation, the selection committee determines whether to clear the candidate as medically and psychologically appropriate to be a donor. Once the donors receives clearance, we schedule them for surgery based on their availability.”

The living donor coordinator follows up with the donor on the first postoperative day and stays in touch through discharge and recovery at home.

“We place follow-up phone calls to check on living donors and encourage them to reach out to us anytime,” Jones says. “We follow up seven to 10 days after donation and again at six months, one year and two years after surgery.”

For Jones, the most challenging aspect of her role as a living donor coordinator is informing patients that a medical condition or another factor will preclude them from donating a kidney to a loved one.

“When people aren’t a candidate to be a living donor, I encourage them to maintain their health to avoid becoming someone in need of a transplant,” Jones says. “I educate them about maintaining a healthy lifestyle, and I encourage them to be a donor champion for their loved one to see if someone else can step forward and donate an organ.”

Dr. Rauf Shahbazov, surgeon and assistant professor of surgery at Upstate Medical University, speaking with Transplant Coordinator Tanya Mercurio, MSN, RN.
 

Growth Trajectory

The need for organ transplants continues to grow. In 2021, new Upstate Transplant Program waitlistings increased by 54%, the number of transplants increased by 50%, and the number of living-donor kidney transplants increased by 78%. The program is well-positioned to meet this expanding need. Advances in care — including robotic surgery for kidney recipients (see “A New Era for Transplant Surgery in Central New York”) and evolutions in treatment that allow for the use of organs from hepatitis B- and C-positive donors — allow the program to offer transplants to more patients.

“We recently added an outreach coordinator to our staff, which further connects us to our community partners and brings our assistance closer to them,” Morris says. “As a result, we hope to be able to waitlist even more patients in our area and beyond. In addition, we are part of the National Kidney Registry, which helps us assist transplant candidates in finding better living-donated kidney matches. We have the expertise to pick the right organ for each patient and transplant it well.”

As the Upstate Transplant Program grows, its nurses are poised to play a central role.

“Referring nephrologists and other providers can count on us as a strong nursing team with many years of experience,” Jones says. “We’re a caring group of nurses who will give our all to help every patient succeed in our program.”

A hallway in the Transplant suite at Upstate University Hospital bears a large map of the 50 states and U.S. territories filled with colored pins, including Puerto Rico and Hawaii. Each pin represents an Upstate transplanted patient. Not surprisingly, a large number appear in New York state.

A New Era for Transplant Surgery in Central New York

Minimally invasive techniques have significantly altered the surgical landscape for organ donors and recipients alike.

“There have been many advances in surgical techniques,” says Reza Saidi, MD, FACS, FICS, Chief of Transplantation at Upstate University Hospital and Associate Professor of Surgery at Upstate Medical University. “We see many patients with complex anatomy because of previous disease or previous transplantation, and we have an experienced surgical team equipped to handle these cases. In the past, people who wanted to donate a kidney had to undergo an open procedure. With the advent of minimally invasive techniques and robotics, we can do this operation in a less invasive manner, with patients enjoying rapid recoveries.”

Surgeons with the Upstate Transplant Program have performed robotic donor nephrectomies for about five years. Currently, these procedures require only a one-night hospital stay, and patients can return to their normal activities in two weeks, according to Dr. Saidi.

The use of robotics to perform transplant surgeries has trailed its application to donor nephrectomies due, in part, to the greater complexity of the former. Soon, however, prospective kidney recipients in Central New York and neighboring states will have access to robotic surgery. Later this year, the Upstate Transplant Program will begin performing robotic transplant surgery using the da Vinci Xi surgical system.

Robotic transplant surgery improves surgeons’ ability to connect blood vessels. It also reduces complications. Crucially, robotics improve safety for patients with a high BMI.

“The main advantage of robotics is for patients who are obese,” Dr. Saidi says. “For these patients, open transplants are more difficult, and sometimes, they’re associated with morbidity. Using the robot, we can operate on these patients in a much safer manner and improve access to transplantation for this population. Any transplant patient can be a candidate for robotic surgery, but patients who are obese are especially good candidates because open procedures are so challenging for them.”

With demand for organ transplants high, Dr. Saidi views the addition of robotic kidney transplant surgery as another way Upstate can expand patients’ access to transplantation.

“I’d like referring physicians to know that if they have a challenging patient who’s waited many years for a transplant, they should consider offering their patient the opportunity to come to our program,” Dr. Saidi says. “We can significantly improve the patient’s access to transplantation.”

For more information, visit upstate.edu/transplant.

Rome Health Medical Center: Coordinated for Comprehensive Patient Care

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By Elizabeth Landry

Thursday, August 18, 2022

“The best care out there. Here.”

Rendering of Rome Health Physician Center lobby
 

That’s the motto at Rome Health, an organization that is always focused on community and striving each day to provide patients with the best care possible. This commitment will now extend to the new Rome Health Medical Center, which opens this fall.

Located at 1500 N. James St. on the hospital’s main campus, the new Medical Center brings together primary care, surgical specialists, diagnostic testing and retail pharmacy services under one roof for coordinated, comprehensive, individualized patient care.

Careful Planning

Rome Health worked with King + King Architects and the Hayner Hoyt Corporation to design a building that intuitively offers ease of access and straightforward navigation right from the start of a patient’s experience. The new design also kept the provider experience in mind.

Providers from the hospital’s existing off-campus locations will move into the new 31,000-square-foot, two-story Medical Center over the next several months, as each office integrates with the center’s new electronic medical record. The facility includes 41 exam and procedure rooms with primary care, retail pharmacy and lab services on the ground floor. Additional primary care providers, general specialists and those specializing in breast and bariatric surgery will see patients on the second floor.

The proximity of adjacent services at the hospital, including medical imaging, cardiopulmonary services and cardiology, enhances accessibility for patients who may need multiple services but also face transportation difficulties.

PATIENT-CENTERED — Rome Health Chief Operating Officer Ryan Thompson and Chief Medical Officer Cristian Andrade, MD, preview one of the exam rooms in the new Rome Health Medical Center opening in the fall. Each room will have dual monitors so the provider can share information with the patient on a large screen on the wall.
 

Close Collaboration

The Medical Center design supports providers and their care teams in delivering comprehensive care in an environment that is convenient and facilitates important healthcare discussions. Each floor is organized into separate pods, each one consisting of provider offices, a care team station and exam rooms. Allowing medical teams to quickly and easily collaborate enhances communication and supports coordinated patient care.

“This entire initiative really revolves around access to primary care and the coordination of care that comes out of that,” says Michael J. Attilio, MD, Vice President of Physician Practices at Rome Health. “This new space provides us with the opportunity to better integrate local primary care and specialty services, bring people together and have a much more collaborative and interactive environment. Providers can interact more frequently, which in primary care is very valuable. We take care of a very diverse population of individuals. Being able to simply walk next door and ask, ‘Hey, what do you think about this?’ helps us as clinicians to make better diagnoses and better decisions, which helps improve the quality of care our patients receive.”

Ryan Thompson, Chief Operating Officer, Rome Health Medical Center, says increasing ease of communication among providers and staff inherently comes with improved access to the community, as well.

“When we create an environment that supports the workflows of our physicians and nurse practitioners, it’s easier for them to just focus on our patients,” Thompson says. “Efficient workflows help us to increase capacity and offer greater access for our patients.”

TEAM-BASED CARE — Rome Health Chief Operating Officer Ryan Thompson explains how each pod in the new Rome Health Medical Center supports the providers and their care teams in providing the best care out there. Here.
 

A New Electronic Health Record System

Another major component of the new Rome Health Medical Center is an integrated ambulatory electronic health record that will replace the stand-alone systems used by its affiliated primary care, prenatal care services and specialty practices. The new system will allow clinicians to access all of a patient’s medical information within the Rome Health system, regardless of where they were treated. Moving to a single platform also provides patients access to a portal where they can securely obtain their personal health information.

The new system will also help reduce unnecessary over testing and repeat medical testing.

“The integrated health record is going to assist physicians with communication amongst each other so we’re not duplicating efforts and care for patients,” says Chief Medical Officer Cristian Andrade, MD. “There’s going to be better access to those records when patients are admitted to the hospital, reducing the cost and improving efficiency and care for patients. From a population health standpoint, the electronic health record integration also helps with standardizing care for chronic conditions with evidence-based medicine.”

As a whole, the new Medical Center and its integrated systems will create a connected healthcare experience that benefits both patients and providers — a tool to help improve the lives and health of people in Rome and its surrounding communities.

As the official opening of the medical center approaches, the healthcare team at Rome Health will grow alongside the patient population they serve. But no matter where the care is being offered, serving patients with the best, coordinated and comprehensive care will always be at the heart of Rome Health.

“The really important thing I want everyone to reflect on as we move into this space is that at the end of the day, it’s really not about the space, if you think about it. It’s about the people in that space, our people taking care of the people who depend upon us for their care,” Dr. Attilio says. “We want to provide a comfortable, welcoming, high-quality environment for the patients we serve and the healthcare professionals who deliver that care.”

Visit romehospital.org to learn more.

Firefighters: Get screened like your life depends on it

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By Martha Conway

Thursday, August 18, 2022

CRA Medical Imaging talks about firefighter health, low-dose CT Medicare expansion

CRA Medical Imaging, one of the largest diagnostic imaging practices in Central New York, strives to deliver the best care for the best patient outcomes possible. CRA Medical Imaging has zeroed in on a particular population: Firefighters. Cancer is the leading cause of line-of-duty deaths for firefighters, followed by heart disease. The Syracuse municipal health plan offers firefighters earlier access to potentially life-saving screenings, which are offered in collaboration with Crouse Medical Practice – Cardiology, Crouse Radiology Associates, Empire Dermatology, Fayetteville Dermatology and Hematology-Oncology Associates of CNY.

Screenings, like smoke detectors, save lives

Cancer is the most dangerous threat to firefighter health and safety, causing 66% of career firefighter line-of-duty deaths (LODDs) from 2002 to 2019 and 70% of LODDs for career firefighters in 2016, according to data from the International Association of Fire Fighters. Heart disease caused 18% of career LODDs for the same period.

Firefighters have a 9% higher risk of being diagnosed with cancer and a 14% higher risk of dying from cancer than the general U.S. population, according to research by the CDC’s National Institute for Occupational Health and Safety. The most prevalent cancers were respiratory (lung, mesothelioma), GI (oral cavity, esophageal, large intestine) and kidney; however, firefighters also have twice the risk of developing testicular cancer and mesothelioma; about 1.5 times the risk of developing multiple myeloma, non-Hodgkin’s lymphoma and skin cancer; and about 1.25 times the risk of developing malignant melanoma, brain cancer, prostate cancer, colon cancer and leukemia.

Most screenings — which include testing for colorectal, prostate, kidney, bladder, thyroid and lung cancers, as well as EKGs, cardiac stress tests and cancer genetics screening surveys according to age and circumstances — can be completed during annual Firefighter Screening Days, but individuals can make appointments that are more convenient for them.

Since 2005, the nonprofit Firefighter Cancer Support Network (FCSN) has assisted and provided one-on-one mentoring to thousands of cancer-stricken firefighters and their families. FCSN also delivers cancer awareness and prevention training nationwide. For more information, visit firefightercancersupport.org/resources/faq.

Updated reimbursement policies sure to improve lung cancer screening rates

Earlier this year, the Centers for Medicare and Medicaid Services (CMS) released a detailed summary of expanded reimbursements involving low-dose computed tomography screening for lung cancer.

According to reporting by Dave Fornell in the March 11 issue of Computed Tomography, the move is expected to increase access to this critical diagnostic tool. In Fornell’s article, ACR Principal Economic Policy Analyst Alicia Blakey said there is a concerted effort to increase screenings for lung cancer and awareness of the availability of low-dose CT scans. Blakey said the goal is to find and treat lung cancer in its earliest stage, particularly in high-risk, asymptomatic individuals.

Lung cancer is the leading cause of cancer-related deaths in the U.S.; about 85% of lung cancer deaths occur in current or former cigarette smokers. The most common cause of lung cancer deaths is non-small-cell lung cancer.

CMS changes lower the screening age, shorten the length of annual cigarette consumption, expand access for commercial payers and Medicaid expansion states, and lower the age for screening to accommodate younger and disabled people, all of which will expand low-dose CT screening, particularly to historically underserved populations and people who have shorter smoking histories.

Submitting a scheduling request form (crouse.org/firefighterform/) will help expedite registration; for more information or to register by phone, contact Marianne Kokosenski at 315-472-7504 Ext. 1349 or email mkokosenski@hoacny.com.

When registering for screenings, participants may opt to get an eight-week trial membership at the YMCA of Central New York. For more information on the program and participating branches, visit crouse.org/wp-content/uploads/2022/03/Oncology-Trifold-Brochure-1-compressed.pdf.

Those needing a primary care physician may get help finding a provider by emailing navigator@crouse.org or calling 315-470-8034; visit crouse.org/providers for a list of Crouse Health Network primary care practices.

Leaders in the Field of Medical Imaging

For CRA Medical Imaging, part of their mission is to be first in the field in every way. Their staff have decades of experience, and their facilities — which are ACR-accredited in mammography, CT, nuclear medicine and PET/CT — tout the best equipment and services in ultrasound, X-ray, MRI, computed tomography, PET/CT, nuclear medicine, 3D digital mammography and interventional radiology.

Clinical quality and service to patients and referring providers are top priorities for CRA Medical Imaging, and these factors provide patients a higher standard of imaging quality, care and radiation dose protection.

CRA has locations in Syracuse, Auburn, Fulton and Oswego, where diagnostic testing including ultrasound, X-ray, MRI, CT, PET/CT, nuclear medicine, 3-D digital mammography and interventional radiology are performed in a friendly, efficient environment. For more information about CRA Medical Imaging, call 315-234-7600 or visit craimaging.com.


Phillips Vereos PET/CT Scanner

Improving Community Health

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By Kathryn Ruscitto

Thursday, August 18, 2022

So much of what we are dealing with in our society can be addressed by improving community health

Besides socioeconomic factors, the physical environment, health behaviors, and access to clinical care — when rolled together — produce good or bad health outcomes, as noted by the CDC. Clearly, we know many diseases cannot be cured, but if we prevent the illness to begin with, results include a better outcome for the patient, and reductions in the use and cost of treatment.

I spend a great deal of time focused on the social determinants of health outcomes, and specifically advocating for Lyme disease research. The emergence of new viruses, escalating drug abuse, and gun violence have also contributed to growing concerns about prevention and treatment in our communities. The list could go on and on, but strategies to improve health outcomes in one area often spill over to positive impacts in other areas. The best example is exercise and weight reduction, and the impact that has on many chronic illnesses.

Community Health Is Everyone’s Responsibility

It’s not only the health department’s job — whether local or national — to set the stage for better community health. If organizations and employers promoted more educational initiatives for tobacco cessation, physical activity, nutrition counseling, CPR, and screenings for cholesterol, blood pressure and diabetes, we would inevitably improve community health.

The CDC reports that 19% of U.S. employers currently offer tobacco cessation programs and 17% offer programs to address obesity and weight management. Surely, there’s room for growth, and plenty of resources are readily available.

Kathryn Ruscitto

Franklin Fry, Executive Director of the American Heart Association in Syracuse, suggests clinicians should remember and utilize free programs and resources offered by organizations such as the American Heart Association. In Central New York, the AHA’s priorities include addressing hypertension through programming around self-monitoring of blood pressure, improving nutritional security for SNAP users by promoting additional benefits for fruits and vegetables, and ensuring families are educated on cardiac emergency response through the teaching of Hands-Only CPR.

As our health organizations face COVID-19 and workforce shortages, the ability to offer community based screenings and health promotions has eroded. What can our practices, churches and social organizations to do help? Get behind programs you can sponsor, those that put the tools in the hands of patients to improve their health and their families’ health.

Resources

  1. cancer.org/about-us/what-we-do/health-equity.html (American Cancer Society)
  2. cdc.gov/chinav/database/index.html (CDC: Community Health Improvement Navigator)
  3. cnylymealliance.org/ (Lyme Alliance)
  4. cpr.heart.org/en/training-programs/community-programs (American Heart Association, CPR)
  5. diabetesjournals.org/care/article/45/Supplement_1/S8/138915/1-Improving-Care-and-Promoting-Health-in (American Diabetes Association)
  6. heart.org/syracuse (American Heart Association, Syracuse)
  7. rwjf.org/en/our-focus-areas/focus-areas/healthy-communities.html (RWJ, Healthy Communities)

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com.

Be Careful of the SLAPP-back

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By Laura Spring, Esq.

Thursday, August 18, 2022

Pursuing a defamation claim for a negative social media review is a hard road at best.

Social media is ubiquitous. Nearly every organization or business — including medical practices — is being reviewed by customers and patients who can easily and publicly disseminate their point of view across the internet. Sometimes those reviews seem unduly harsh or unjustified, but there are good reasons for medical practices to not launch a legal response.

Different standards govern defamation. Whether the plaintiff is a public or private figure, or the matter is one of public interest, there is generally a high bar to winning a defamation suit in the United States. Courts tend to construe ambiguous or unclear language in favor of the defendant.

There must also be an objectively false statement that can be judged as such for the plaintiff to prevail in a defamation case. A mere statement of opinion is almost certainly not enough. Subjective opinions are almost always going to be considered protected speech, which makes a review on social media difficult to prove as defamation.

Laura Spring, Esq.

Anti-SLAPP Laws Raise the Bar Even Higher

Beyond the robust First Amendment’s protection of speech, which makes winning a defamation suit difficult, many states, including New York, now have anti-SLAPP statutes that further protect speech related to public matters.

SLAPP is an acronym for “strategic lawsuits against public participation,” meaning lawsuits that have little to no legal merit, but are filed anyway in order to intimidate the defendant or inundate them with costs related to legal proceedings. SLAPP suits are a weapon in the arsenal of those with deep pockets who aim to silence opposition.

Initial New York anti-SLAPP statutes focused on speech during public meetings about land use development. In 2020, the anti-SLAPP statute was expanded to include “any communication in a place open to a public or a public forum in connection with an issue of public interest.” The statute tells the courts to interpret “public interest” as broadly as possible.

The Public Forum Expands

Social media is interpreted as a public forum, and court cases have shown that reviews of businesses on social media sites will fall into the category of “public interest.”

One recent case, Aristocrat Plastic Surgery v. Silva, determined the reviews of medical treatment performed by doctors were a matter of public interest and therefore, the negative online reviews were protected speech. Since the court determined the negative review fell under New York’s anti-SLAPP statute, the defendant was subsequently entitled to obtain damages and attorneys’ fees from the doctor who initiated the defamation claim.

The bottom line: Legal responses to negative reviews of businesses are unlikely to succeed. Perhaps more importantly, due to New York’s anti-SLAPP statute, any business owner — including a medical practice — could be on the hook for damages and legal fees if it brings a lawsuit covered by the statute. It is wise to tread carefully when considering a response to a negative review and it is almost certainly not worth bringing a lawsuit against the negative reviewer.

Spring is a partner at ccblaw in Syracuse, New York. She can be reached at lspring@ccblaw.com.

Accelerated Recovery Without Opioid Risks: How New York Surgeon Andrew Wickline Reinvented the Joint Replacement Experience

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By Elesa Swirgsdin

Friday, June 17, 2022

Andrew Wickline, MD, is raising the bar on total knee and hip replacements with game-changing protocols that minimize the need for pain medications while maximizing results.

Andrew Wickline, MD, Nicole Urbanke, RN, Jodi Pearsall, RN, Kristin Thayer, ST, Stevana Hanna, ST, Dana Siriano, RN, Paul Crescenzi, CRNA
 

Total knee and total hip replacements typically lead to painful recovery periods filled with difficult physical therapy sessions. Not only does this deter some patients from getting a procedure that can vastly improve their quality of life, but it also raises the risk of patients developing an opioid dependency after surgery.

Andrew Wickline, MD, an orthopedic joint replacement specialist at Genesee Orthopedics & Plastic Surgery in New Hartford, located about 50 miles east of Syracuse, has proven this troubling trend doesn’t have to continue. After developing Therapy-Free Total Knee Replacement, a program that virtually eliminates the need for traditional physical therapy following a joint replacement, Dr. Wickline published the lowest opioid use rates in the country for this type of procedure, with high patient satisfaction and positive long-term outcomes.

His groundbreaking protocols have also led to the lowest patient costs and the lowest complication rate in the state of New York, even among patients with a high number of comorbidities.

Responding to Patient Needs

“At the end of the day, a huge part of a doctor’s job is customer service,” Dr. Wickline says. “I asked my patients, what can I do better? The answers made me think about why we do such aggressive physical therapy after joint replacements, and if there could be a better way. That was the inspiration for developing my therapy-free program.”

Many patients told Dr. Wickline that the joint replacement surgery itself wasn’t a bad experience, but the physical therapy prescribed during recovery was nearly unbearable, especially for total knee replacements.

“I heard things like, ‘I hate therapy. It was absolutely terrible.’ Or ‘My mom won’t go back to do the other knee because she doesn’t want to go through therapy again,’” Dr. Wickline says. “I started looking at what we could do differently.”

Some patients also had to travel long distances for physical therapy, which presented a significant obstacle to a successful recovery. After developing an at-home therapy plan for these patients, Dr. Wickline found that they experienced less pain, better range of motion, and a faster overall recovery than those who followed a traditional, intensive inpatient physical therapy program. This success has been seen with patients from Pakistan, southeast Asia, Canada, the Caribbean, Texas, North Carolina, New Jersey, Maine and Pennsylvania.

 Andrew Wickline, MD

Siobhan Fitzgerald, RN, BSN, Nurse Administrator

Apex Surgical Center

Exceeding Expectations

Dr. Wickline began using a home-therapy method for all of his patients combined with a comprehensive education and optimization plan. The results showed not only an easier recovery, but patients needed drastically fewer narcotics for pain relief following surgery. In 2020, he published the results of his new study, in the Journal of Orthopaedic Experience & Innovation. It involved 386 patients who had total knee replacement. During a 12-week period, 86.3% of patients needed 10 or fewer opioid pills, while 18.9% used zero opioids.

Dr. Wickline’s results are 16 times less than the national average and five times less than the next best published opioid reduction paper from Mayo Clinic.

“I saw a new study that said the average across the country is 1,200 morphine milligram equivalents for the three-month period after total joint replacement,” Dr. Wickline says. “That’s around 160 oxycodone 5mg pills for 90 days — compared to 10 pills or less with my protocol. There is still a disconnect, and we need better opioid stewardship in New York and across the country.”

In 2021, more than 107,000 people in the United States died from opioid-related overdoses. According to some studies, between 8% and 12% of people who are prescribed opioids for pain after joint replacement may develop an addiction.

Dr. Wickline’s approach replaces the typical 90-minute physical therapy sessions three times a week with four simple 8-minute exercises once an hour. Using elevation and ice after the exercises also keeps swelling down, which further decreases pain.

“If you sprain your ankle badly, you’re not going to do a 90-minute workout three times a week,” he says. “It turns out that you don’t need to do aggressive, tortuous therapy if you control swelling. Formal therapy is best used to fine tune recovery at five to six weeks after surgery.”

More than 85% of patients in Dr. Wickline’s study did not need formal physical therapy, leading to an average personal savings of $720 in therapy copays and more than $3,000 savings to insurers. In addition, 64% of patients in the study went home the day of surgery and 91% were discharged within 23 hours. Currently, 95% of patients go home the same day their joint was replaced.

Patients who follow the program also experience significantly fewer complications.

“Our readmission rate is 1.2%. That is markedly lower than results published by some big institutions,” Dr. Wickline says. “That’s also where cost is kept down. If you get readmitted for a fracture, suddenly the cost for that patient has gone up dramatically. According to Medicare cost data, I have the lowest 90-day cost in the state, even though my patients have a higher number of medical issues.”

Contributing Success Factors

Dr. Wickline is among a small percentage of surgeons in the country performing tourniquet-free knee replacements. This practice lowers the risk of blood clots by 19%. It also reduces pain and infection risk and improves incision healing.

In addition, Dr. Wickline is the only site in New York offering personalized kinematic alignment and medial pivot knee replacement. It restores each patient’s normal anatomy of the knee and provides knee motion that most closely resembles that of the native join — without painful ligament releases that increase swelling.

Improving nutrition with branched-chain amino acid protein supplementation and specific anti-inflammatory diet changes also plays a significant role in an accelerated recovery program.

Lastly, Iovera cryoablation, a temporary freezing treatment around the knee, provides patients with three months of post-op pain reduction.

Total Hip Replacement Results

Dr. Wickline delivers similarly impressive results for patients undergoing total hip replacement. In 2020, he published another study in the Journal of Orthopaedic Experience & Innovation reporting the results of a six-week long study following 207 patients after their hip replacement. About 97% of these patients required 10 opioid pills or less, with the average being 3.5 pills per patient in the six weeks following surgery. Patients followed a home-therapy protocol and 95% were able to skip formal physical therapy at six weeks. He has used the muscle sparing anterior hip approach since 2007.

Preparing Patients for Success

Comprehensive patient education is a critical component of Dr. Wickline’s program.

“No one prepares for the Super Bowl the day before the game. They prepare for weeks ahead of time,” he says. “It’s the same with joint replacement.”

Dr. Wickline has written two separate patient books for knee and hip replacements, each about 65 pages long. The goal of the books — now in their 13th edition — is to help patients succeed with proper preparation prior to surgery. The books cover topics like nutrition, getting the living space ready, and what to expect every step of the way before and after surgery, as well as during recovery.

“They answer pretty much every question that a patient has asked over the last 20,000 plus surgeries,” Dr. Wickline says. “They are extremely comprehensive.”

The books are designed to be read at certain intervals prior to surgery, so that patients can, for example, change their diet four weeks before the procedure to set themselves up for a successful recovery. An app is currently in development for patients who prefer watching videos more than reading.

Ongoing Research

Dr. Wickline continues to study opportunities to optimize recovery protocols. His research focuses on the correlation between swelling and pain and is a main focus of his current research.

“The more you control swelling, the better the joint feels,” he says. “We’re doing 3D optical scanning where we’re looking at several different infection control protocols to see if they reduce swelling. We’re also performing bioimpedance testing to look at how much fluid is in the leg before and after surgery. It’s about creating a normative baseline so we can start adding or subtracting different things from the protocol to see what improves or worsens swelling.”

Dr. Wickline also participates in the geko Cross Therapy Registry for Edema, a clinical trial that collects data on how geko neuromuscular electrostimulation technology affects swelling.

Another research focus area centers on the effectiveness of various non-opioid pain management methods, such as pre-op cryoablation, which Dr. Wickline offers to help reduce post-op pain for up to three months without narcotics. He is involved in a study focusing on how long various pain relief methods last and what is most effective for patients with osteoarthritis.

Prominent Surgeons Adopt New Joint Replacement Protocol

After Andrew Wickline, MD, published his studies on therapy-free joint replacement, orthopedic surgeons around the country, as well as in other parts of the world, began to take a keen interest in his method.

Andrew Wickline, MD

“I was having great success with my total hip and total shoulder patients, but my total knee patients seemed to suffer,” says Chris Mellano, MD, orthopedic surgeon in Manhattan Beach, California. “I commonly heard patients say, ‘I hope I never have to do that again.’ I was searching for a way to make the experience easier and less painful.”

Dr. Mellano came across Dr. Wickline’s study on therapy-free knee replacement — and couldn’t believe what he was reading.

“A large percentage of patients used no narcotics after surgery, which is unheard of in my experience,” he says. “Most also did not require formal outpatient therapy, another astounding accomplishment.”

Dr. Mellano was further shocked to find that the patients in the study were not hand-picked to be ideal patients and instead included people of all ages, including those with multiple comorbidities.

Dr. Mellano decided to visit Dr. Wickline’s practice to observe his protocols firsthand. What he saw validated the published results and inspired him to adapt these new techniques into his own practice.

“The most important factor I learned was exceptional dedication to patient education,” Dr. Mellano says. “Patients went into surgery with a clear understanding of the procedure and how to optimize their outcome. On a surgery day, Dr. Wickline and his team efficiently performed multiple total joint replacements without sacrificing patient care in any way. I left feeling empowered by his example.”

After returning to his practice, Dr. Mellano began implementing many of Dr. Wickline’s protocols, including providing patients with educational guides.

“My results have been transformative,” he says. “The first five patients each took zero narcotics and told me that their outpatient total joint procedure was a wonderful experience.”

Far-Reaching Benefits

Dr. Mellano is not alone in his experience. Michael Engl, MPH, a board member of the elite European Knee Associates, who operates in northern Italy, recently traveled to New York to observe Dr. Wickline’s protocols in action.

“Here in Europe, total joint replacements that allow patients to leave the hospital after a few hours is very uncommon,” he says. “It was almost unbelievable. By visiting Dr. Wickline, I am convinced that the knowledge I gained is as high as that of attending international meetings. It was very inspiring to discuss the differences in our pathways.”

Stephen Howell, MD, knee arthroplasty surgeon at Adventist Health Lodi Memorial in Lodi, California, known for his role in helping develop the kinematic alignment method, was looking for a way to perform outpatient total knee replacements when COVID-19 stopped elective inpatient procedures.

“Since adopting Dr. Wickline’s protocols in July 2020, nearly all of our TKA procedures have been outpatient,” Dr. Howell says. “His pain program works synergistically with the kinematic alignment approach. These techniques complement and potentiate each other.”

Looking to the Future

Dr. Wickline hopes that more surgeons across the country will adopt his unique protocols into their practices to reduce the need for narcotics and improve patient outcomes. Several prominent surgeons have already incorporated his techniques into their own protocols, an encouraging sign (see sidebar on page 8).

“It can be hard to get people convinced because these methods are so different, and change can be scary,” Dr. Wickline says. “But the bottom line is if patients follow the program, they’re going to have great outcomes. The key is getting patients engaged. You just have to give them the winning game plan.”

Dr. Wickline earned the 2020 Excellence in Surgery award at the 9th Annual Excellence in Healthcare Awards presented by the Central New York Business Journal. Visit andrewwicklinemd.com to schedule an appointment. You can also call his personal assistant, Mrs. Lorilynn Szkotak, at 315-738-5069.

The Right Way to Curb Opioid Abuse by Americans

Did you know that your grandma could become addicted to opioids because of a knee replacement? It’s more likely than you might think. Knee replacements — with more than 1 million performed every year — nearly always require opioids for pain control. It’s no surprise that the proportion of older adults seeking treatment for opioid abuse nearly doubled in recent years, particularly as the number of joint replacements increased drastically.

Every pill surgeons order can cause substance abuse. A 10-day opioid supply carries up to a 20% risk of addiction. A 24-hour supply runs a 6% chance of addiction. By getting their wisdom teeth pulled, your teenager — consuming opioids for one day — could develop an addiction. Approximately 80% of heroin addicts first misused prescription narcotics.

I propose a radical solution …

Excerpted from an op-ed in the New York Daily News by orthopedic joint replacement specialist Dr. Andrew Wickline on how to immediately begin reducing opioid addiction. To read the full article, visit nydailynews.com and search for Wickline. Siobhan Fitzgerald, RN, BSN, Nurse Administrator

New York Medical Malpractice Market Trends

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By Jenn Negley

Friday, June 17, 2022

Frequency and severity of claims, social inflation, and tort reform are the key drivers pushing malpractice carriers to seek increases during a hard market or reductions in a soft market.

While New York was slower to transition to the soft market of the past 20 years, the good news is that the same might be true of the significant increases we are now seeing in other states. As reported by the American Medical Association, “Rates that jumped 10% or more between 2020 and 2021 were reported in 12 states.”

See below for those states, listed with the share of comparisons reflecting increases of that size:

  • Illinois: 58.9%
  • West Virginia: 41.7%
  • Missouri: 29.6%
  • Oregon: 20%
  • South Carolina: 16.7%
  • Idaho: 11.1%
  • Kentucky: 7.4%
  • Delaware: 6.7%
  • Washington: 6.7%
  • Michigan: 5.4%
  • Texas: 4.9%
  • Georgia: 3.7%


Jenn Negley

Recent unprecedented trends have upended the predictability carriers rely on to maintain their financial strength. Prior to COVID-19, the number of shock losses rose at an alarming pace due to so-called social inflation in jury awards not seen in previous years. While carriers continued to lower pricing concurrent with the drop in frequency of claims, they had not factored in the drastic increase in payout amounts.

There is now a concern, post-COVID, that there will be a significant increase in the frequency of claims, making reduced rates unsustainable. There is also a belief that because many patients delayed routine tests and treatments during the pandemic, health complications will increase as conditions progress further than what we normally see.

Most states, even in the most competitive markets, are seeing a third straight year of overall rate hikes. New York lags behind due to less competitiveness and its Department of Financial Services, which exerts more stringent control on rate filings.

Admitted carriers like The Doctors Company, a newer entrant to the marketplace that’s still aggressively pursuing market share, reduced their rates at the end of last year in the central region. While the carrier MLMIC has held steady on rates, with some selective increases per specialty, it also filed discounts through risk purchasing groups to maintain a hold on their market share. On the non-admitted risk retention group side, expect to see some increases, but overall, these carriers will look to keep “good” accounts and maintain rate flexibility, unlike admitted carriers.

All of these factors are driving rate increases in other states. In New York, while some downstate regions are the most litigious in the country, Central New York is not immune either, making it a difficult market to navigate.

It Is Never Tenable to Leave Savings on the Table

As a buyer, it’s important to keep an eye on a carrier’s financials due to the stressors this market creates. It’s also important to engage the market and take advantage of potential savings while it is available. Working with an experienced professional who specializes in malpractice insurance allows you to test the market and avoid costly mistakes. Working with an insurance broker who has a deep understanding and insight into each carrier’s appetite and rate history is key.

While New York is in some ways less dynamic, it can be very difficult to navigate without strong carrier relationships across multiple companies. Be sure to reach out to a specialist before your renewal, even if it is only to review your current policy and confirm you are receiving all the new discounts available.

For more information on your insurance options, please contact Jenn Negley, Vice President, Risk Strategies Company at 267-251-2233 or JNegley@Risk-Strategies.com.

Jenn will be at the NY MGMA convention in Verona June 29–July 1.